The contralateral progression in a cohort of Chinese adult patients with unilateral moyamoya disease after revascularization: a single-center long-term retrospective study

Abstract

Background Moyamoya disease (MMD) is a chronic progressive cerebrovascular disease mainly existing in the Asian population, which can be divided into unilateral and bilateral types. Contralateral progression has been reported in pediatric patients with unilateral MMD, while large series about contralateral progression in Chinese adult patients were rare. The goal of this study is to elucidate the clinical features and incidence of contralateral progression in Chinese MMD adult patients. Methods One hundred one Chinese adult patients with unilateral MMD who received surgery treatments between January 2015 and January 2017 in our hospital were enrolled in this study. This study contained 89 patients. Digital subtraction angiography was performed in all patients for initial diagnosis, and magnetic resonance angiography was repeated 6 months from the initial operation and then annually. Clinical characteristics, contralateral progression, and risk factors were studied. Previous related studies were also reviewed and meta-analyzed. Results Of these 89 patients, contralateral progression was identified in 8 patients (9.0%) within a median follow-up period of 63 months, which was lower than that in previous studies (25.9%). Single-factor analysis and multivariate analysis did not reveal significant risk factors related to the contralateral progression. Conclusion The progress rate in this cohort of Chinese adult patients with unilateral MMD after revascularization was 9.0%, which indicates that some of the unilateral MMD were an early form of bilateral MMD rather than a separate condition. Trial registration. This work was approved by the Medical Ethics Committee of Zhongnan Hospital of Wuhan University (approval number: Kelun-2017005).

Dilated perivascular spaces and steno-occlusive changes in children and adults with moyamoya disease

“…MMD is a slowly progressive disease. It usually begins on both sides, but may not begin at the same time and may not deteriorate at the same speed [ 21 – 23 ]. Even if the causal relationship between steno-occlusive change and DPVS is not understood fully in MMD, it may require a considerable time for steno-occlusive change to expand the PVS.…”

Potential predictors for progression of moyamoya disease: A systematic review and meta-analysis

“…These studies were excluded because they were not original research, didn't mention potential predictors or unable to extract data. Finally, 12 studies enrolling a total of 842 patients (158 patients with progression and 684 patients with non-progression) were included in the meta-analysis (2,12,(14)(15)(16)(20)(21)(22)(23)(24)(25)(26). The flowchart for studies screening was presented in Figure 1.…”